• Title/Summary/Keyword: Endometrial Carcinoma

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Survival Rate of Early Stage Endometrioid Adenocarcinoma of Endometrium Treated at Srinagarind Hospital

  • Krusun, Srichai;Pesee, Montien;Rasio, Withee;Tangvoraphonkchai, Vorachai;Supaadirek, Chunsri;Thamronganatasakul, Komsan;Supakalin, Narudom;Padoongcharoen, Prawat
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2217-2220
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    • 2014
  • Purpose: To evaluate the survival outcome of early stage endometrioid adenocarcinoma of the endometrium with risk factors for locoregional recurrence treated with combined pelvic external beam radiotherapy (EBRT) and vaginal brachytherapy (VBT) after comprehensive surgery. Materials and Methods: Post-operative radiotherapy by pelvic EBRT and VBT for early stage endometrioid endometrial carcinoma resulted in excellent pelvic control with acceptable complications. This study showed no significant relationships between age, stage, histologic grade and LVSI and overall survival rate. Results: The 5-year overall survival rate (OS) of early stage endometrioid type of endometrial carcinoma was 85.7%. Acute toxicity occurred in 38.1% of the patients, all of whom were grade 1 or 2. Total late toxicity developed in 42.9% of study group, in which 36.99% of them were grade 1-2 and 4.76% were grade 3-4. Conclusions: Post-operative radiotherapy by pelvic EBRT and VBT is acceptable for early stage endometrioid endometrial carcinoma, independent of age, stage, histologic grade and LVSI.

Polymorphism of p53 Gene Codon 72 in Endometrial Cancer: Correlation with Tumor Grade and Histological Type

  • Kafshdooz, Taiebeh;Tabrizi, Ali Dastranj;Ardabili, Seyyed Mojtaba Mohaddes;Kafshdooz, Leila;Ghojazadeh, Morteza;Gharesouran, Jalal;Abdii, Ali;Alizadeh, Hamideh
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9603-9606
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    • 2014
  • Background: Endometrial cancer is the fourth most common cancer among women in developed countries. Patients with endometrial cancer may benefit from systemic chemotherapy alone or in combination with targeted therapies if the disease is clinically diagnosed prior to spread and metastasis to other organs. The aim of this study was to evaluate the prognostic role of p53 polymorphism and its correlation with tumor grade in human uterine endometrial carcinomas. Materials and Methods: A total of 75 patients with endometrial carcinomas were studied for possible mutations in exon 4 of the p53 gene using polymerase chain reaction and restricting fragment length polymorphism techniques and sequencing. Results: In recent study, The rate of homozygote genotype of pro/pro or Arg/Arg in high grade group was higher than in comparison with low grade one. In addition samples that were undigested in RFLP, showed mutation in exone 4. Conclusions: Our findings showed that high grade endometrial carcinomas are highly associated with TP53 polymorphisms in comparison with low grades.

A clinical case of abnormal uterine bleeding owing to endometrial hyperplasia (자궁내막증식증에 의한 붕루 환자 치험 1예)

  • Park, Young-Sun;Kim, Dong-Chul;Baek, Seung-Hee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.18 no.3
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    • pp.215-224
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    • 2005
  • Purpose : Endometrial hyperplasia(EH) is an abnormal proliferation of the glandular component of the endometrium. And also EH is relateted to endometrial carcinoma clinically. Hysterectomy is the common treatment for EH patients in western medicine, but this treatment is the invasive treatment for women. The purpose of this study is to report the effect of oriental treatment for an abnormal uterine bleeding owing to endometrial hyperplasia. Methods : This study is about metrorrhagia owing to EH for three years. This report is performed to observe medication of Guichulpajing-tang(歸朮破?湯) diagnosed as blood stasis in oriental medicine view. Results : The uterine bleeding of the EH was reduced gradually during first menstual cycle and was not repeated. The uterine bleeding disappered from the next menstual cycle. Furthermore, the BBT has been stable during 2 menstual cycles and endometrial thickness has been thined remarkably by pelvic sonogram. Conclusion : This case showed successful oriental herbal medication for EH and further study will be investigated in oriental medicine for treatment of EH completely.

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Risk Factors of Lymph Node Metastases with Endometrial Carcinoma

  • Cetinkaya, Kadir;Atalay, Funda;Bacinoglu, Ahmet
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6353-6356
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    • 2014
  • Background: The purpose of this study was to investigate and evaluate risk factors for lymph node metastases (LNM) in cases of endometrial cancer (EC). Materials and Methods: A retrospective single institution analysis of patients surgically staged for EC at Ankara Oncology Education and Research Hospital from 1996 to 2010 was performed. Roles of prognostic factors, such as age, histological type, grade, depth of myometrial invasion, cervical involvement, peritoneal cytology, and tumor size, in the prediction of LNM were evaluated. Fisher's exact test and logistic regression analysis were used to assess the effects of various factors on LNM. Results: LNM was observed in 22 out of 247 patients (8.9%) and was significantly more common in the presence of tumors of higher grade, deep myometrial invasion (DMI), cervical involvement, size >2cm, and with positive peritoneal cytology. Logistic regression analysis revealed that DMI remained the only independent risk factor for LNM. NPV, PPV, sensitivity, and specificity for satisfying LNM risk were 98.0, 19.5, 86.3, and 65.3%, respectively for DMI. Conclusions: The incidence of LNM is influenced independently by DMI. If data support a conclusion of DMI, LND should be seriously considered.

Cytologic Features of Endometrial Hyperplasia : Comparison with Normal Endometrium and Endometrial Adenocarcinoma (자궁내막증식증의 세포학적 고찰: 정상자궁내막세포 및 자궁내막선암종과 비교)

  • Hong, Sung-Ran;Seon, Mee-Im;Kim, Yee-Jeong;Chun, Yi-Kyeong;Kim, Hye-Sun;Kim, Hy-Sook
    • The Korean Journal of Cytopathology
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    • v.11 no.1
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    • pp.1-10
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    • 2000
  • The purpose of this study is to describe the cellular characteristics of endometrial hyperplasia without/with atypia in cervical smears. These cellular features were compared with those of normal endometrium and endometrial carcinoma. We reviewed 265 cervical smears : 64 normal proliferative endometrium, 118 endometrial hyperplasia without atypia, 21 endometrial hyperplasia with atypia, and 62 endometrial adenocarcinoma. Of these smears, 72(27.2%) smears which had diagnostic endometrial epithelial cells were selected for this study. The cytologic abnormalities about cellularity, background, changes in cellular architecture, alterations in nuclear size, anisokaryosis, chromatin pattern, nucleoli, cytoplasmic vacuoles, and mitosis were observed. Nuclear enlargement(1.6 to 2 times of the nucleus in the intermediate squamous cell) and anisokaryosis(${\geq}$2 fold in size variation) were highly suggestive of endometrial hyperplasia without/with atypia. The nuclei from endometrial hyperplasia with atypia were more coarsely granular in chromatin patterns than hyperplasia without atypia(33.3% vs 3.4%). Micronucleoli were observed in all endometrial conditions, but the presence of macronucleoli were more suggestive of hyperplasia with atypia(22.2%) and adenocarcinoma(55%). The changes in cellular architecture(loss of polarity, uneven internuclear distance, overlapping and loose arrangement) were seen in hyperplasia with atypia and adenocarcinoma. Characteristically, bloody background was seen in endometrial hyperpiasia, and cellular detritus or granular proteinaceous material was only observed in endometrial adenocarcinoma. Mitoses were also observed in adenocarcinoma. In conclusion, although there is no single parameter useful for the cytologic differential diagnosis of endometrial lesions, combined cytologic evaluation can be used to diagnose hyperplasia cytologically.

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Utility of Frozen Section Pathology with Endometrial Pre-Malignant Lesions

  • Oz, Murat;Ozgu, Emre;Korkmaz, Elmas;Bayramoglu, Hatice;Erkaya, Salim;Gungor, Tayfun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6053-6057
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    • 2014
  • Aim: To determine utility of the frozen section (FS) in the operative management of endometrial pre-malignant lesions. Materials and Methods: We retrospectively analyzed patients who underwent abdominal hysterectomy with preoperative diagnosis of complex atypical endometrial hyperplasia (CAEH) and simple endometrial hyperplasia (SEH) between May 2007 and December 2013. Frozen and paraffin section (PS) results were compared. Sensitivity, specificity, the positive predictive value (PPV), the negative predictive value (NPV) and the accuracy in predicting EC on FS were evaluated with 95% confidence intervals (CIs) for each parameter. The correlation between FS and PS was calculated as an ${\kappa}$ coefficient. Results: Among 143 preoperatively diagnosed CAEH cases, 60 (42%) were malignant and 83 (58%) were benign in PS; and among 60 malignant cases diagnosed in PS, 43 (71%) were "malignant" in FS. Sensitivity, specificity, PPV and NPV for FS were 76%, 100%, 100% and 87.5%, respectively. Conclusions: We found that FS is reliable and applicable in the management of endometrial hyperplasias. It is important that the pathologist should be experienced because FS for endometrial pre-malignant lesions has significant inter-observer variability. The other conclusion is that patients with the diagnosis of EH, especially those who are postmenopausal, should undergo surgery where FS investigation is available.

Long Term Outcomes of Patients with Endometrial Carcinoma Treated with Radiation - Siriraj Hospital Experience

  • Setakornnukul, Jiraporn;Petsuksiri, Janjira;Wanglikitkoon, Sirentra;Warnnissorn, Malee;Thephamongkhol, Kullathorn;Chansilp, Yaowalak;Veerasarn, Vutisiri
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2279-2285
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    • 2014
  • Background: To evaluate treatment outcomes of patients with stage I-III endometrial cancer treated with postoperative radiation. Materials and Methods: A retrospective review of 166 endometrial cancer patients, undergoing surgery and postoperative radiotherapy at Siriraj Hospital from 2005-2008 was performed. Pathology was reviewed. Results of treatment were reported with 5-year loco-regional recurrence free survival (LRRFS), 5-year overall survival (OS), patterns of failure and toxicity, and according to stage and risk groups. Results: Median follow up time was 62.8 months. Pathological changes were found in 36.3% of the patients after central reviews, leading to 19% changes in risk groups. Most of the patients (83.7%) received pelvic radiation (PRT) and vaginal brachytherapy (VBT). Five-year LRRFS and OS of all patients were 94.9% and 85.5%, respectively. There was no recurrence or death in low and low-intermediate risk groups. For the high-intermediate risk group, 5-year LRRFS and OS were 96.2% and 90.8%, respectively, and for the high risk group 90.5% and 71%. Late grade 3 and 5 gastrointestinal toxicity was found in 3% and 1.2% of patients, respectively. All of them received PRT 5,000 cGy in 25 fractions. Conclusions: Low and intermediate risk patients had good results with surgery and adjuvant radiation therapy. For high risk patients, postoperative radiation therapy alone appeared to be inadequate as the most common pattern of failure was distant metastasis.

Oleanolic acid 3-acetate, a minor element of ginsenosides, induces apoptotic cell death in ovarian carcinoma and endometrial carcinoma cells via the involvement of a reactive oxygen species-independent mitochondrial pathway

  • Jo, Hantae;Oh, Jeong-Hyun;Park, Dong-Wook;Lee, Changho;Min, Churl K.
    • Journal of Ginseng Research
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    • v.44 no.1
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    • pp.96-104
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    • 2020
  • Objectives: Oleanolic acid, a minor element of ginsenosides, and its derivatives have been shown to have cytotoxicity against some tumor cells. The impact of cytotoxic effect of oleanolic acid 3-acetate on ovarian cancer SKOV3 cells and endometrial cancer HEC-1A cells were examined both in vivo and in vitro to explore the underlying mechanisms. Methods: Cytotoxic effects of oleanolic acid 3-acetate were assessed by cell viability, phosphatidylserine exposure on the cell surface, mitochondrial release of cytochrome C, nuclear translocation of apoptosis-inducing factor, depolarization of mitochondrial transmembrane potential (∆Ψm), and generation of reactive oxygen species (ROS). In vivo inhibition of tumor growth was also assessed with xenografts in immunocompromised mice. Results: Oleanolic acid 3-acetate exhibited potent cytotoxicity toward SKOV3 and HEC-1A cells by decreasing cell viability in a concentration-dependent manner. Importantly, oleanolic acid 3-acetate effectively suppressed the growth of SKOV3 cell tumor xenografts in immunocompromised mice. Furthermore, oleanolic acid 3-acetate induced apoptotic cell death as revealed by loss of ∆Ψm, release of cytochrome c, and nuclear translocation of apoptosis-inducing factor with a concomitant activation of many proapoptotic cellular components including poly(ADP-ribose) polymerase, Bcl-2, and caspases-8, caspase-3, and caspase-7. Oleanolic acid 3-acetate, however, caused a decrease in ROS production, suggesting the involvement of an ROS-independent pathway in oleanolic acid 3-acetate-induced apoptosis in SKOV3 and HEC-1A cells. Conclusion: These findings support the notion that oleanolic acid 3-acetate could be used as a potent anticancer supplementary agent against ovarian and endometrial cancer. Oleanolic acid 3-acetate exerts its proapoptotic effects through a rather unique molecular mechanism that involves an unconventional ROS-independent but mitochondria-mediated pathway.

Comparison the Diagnostic Value of Dilatation and Curettage Versus Endometrial Biopsy by Pipelle - a Clinical Trial

  • Sanam, Moradan;Majid, Mir Mohammad Khani
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.12
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    • pp.4971-4975
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    • 2015
  • Background: Several methods have been presented for the evaluation of the endometrium in patients with abnormal uterine bleeding, which include minimal invasive and invasive approaches such as diagnostic curettage or endometrial biopsy by Pipelle. Many studies have been performed in order to compare two methods; diagnostic curettage and outpatient endometrial biopsy. This investigation compared sampling adequacy, endometrial histopathology, failure rates, duration and costs between diagnostic curettage in a hospital and endometrial biopsy. Materials and Methods: This single blind clinical trial was performed on 130 patients older than 35 years who was referred to Amir training hospital in 2013 for elective diagnostic curettage because of abnormal uterine bleeding. For all patients eligible for the study, an endometrial sample by Pipelle was taken without anesthesia or dilatation. Then under general anesthesia diagnostic curettage was performed by sharp curette. Sampling duration was calculated and both samples were sent to the same pathologist. The diagnostic values of two methods in the diagnosis of normal endometrium, endometrial hyperplasia and carcinoma were compared. The costs of these two methods were also compared. Data analysis was performed by SPSS (version 16.0) software. Chi-Square, Fisher, and Pearson tests were used and were considered statistically significant at P values less than 0.05. Results: Two methods were agreed upon 88% of sampling adequacy and 94% of pathological results. Specificity of 100% and sensitivity of 90% for detection of proliferative endometrium, secretory endometrium, simple hyperplasia without atypia and 100% for cancer were recorded. Pipelle diagnostic accuracy in comparison with curettage, have been reported over 97%, so the failure rate in this study was below 5%. Sensitivity of Pipelle for detection of atrophic endometrium was reported below 50%. Duration and cost was lower in Pipelle versus curettage. Conclusions: It is concluded that due to high agreement and cohesion coefficient between curettage and Pipelle on the issue of sampling adequacy, histopathology finding (except atrophic endometrium), low failure rate, duration of sampling and cost, Pipelle can be introduced as a suitable alternative of diagnostic curettage.

Growth Inhibition of Red Ginseng Extracts Against Human Tumor Cell Line by Clonogenic Assay (Clonogenic assay을 이용한 홍삼추출물의 인체종양세포에 대한 증식억제효과)

  • Kim, Chang-Han;Lee, Gyeong-Ho;Byeon, Eun-Gyeong
    • Journal of Ginseng Research
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    • v.22 no.3
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    • pp.188-192
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    • 1998
  • We established the model of clonogenic assay with human tumor cell line such as Calu-3 (lung carcinoma), HEC- lB (endometrial adenocarcinoma) , HEp-2 (larnyx carcinoma), Hs-5787 (breast carcinoma), K-562 (chronic myelogenous leukemia), SF-188 (brain carcinoma), SNU-1 (stomach carcinoma) and WiDr (colon carcinoma) . We investigated growth inhibition of solvent (EtOH, MeOH) and water (100$^{\circ}C$, 121$^{\circ}C$) extracts from Korean red ginseng by clonogenic assay. The results of clonogenic assay showed that EtOH extract had growth inhibition against Calu-3, SF-188 and SNU-1, MeOH extract had growth inhibition against Calu-3, Hs-5787, K-562, and WiDr, but water extract at 100$^{\circ}C$ and water extract at 121$^{\circ}C$ had not growth inhibition against used cell lines.

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